Perception of faces in schizophrenia: Subjective (self-report) vs. objective (psychophysics) assessments
Section snippets
Objectives
Schizophrenia patients have severe social functioning problems in everyday life (Green et al., 2008, Harvey, 2013). Given that human faces provide a rich source of social information, understanding social functioning problems in this psychiatric disorder should begin with and focus on face processing. In fact, face perception impairments have been shown in schizophrenia (Phillips and David, 1995, Chen, 2011, Darke et al., 2014, Bortolon et al., 2015). The impaired perception of faces was
Participants
Thirty-five schizophrenia patients (SZ) participated. All patients met DSM-IV criteria for schizophrenia or schizoaffective disorder, based on a standardized interview (First et al., 1994) and a review of all available clinical records. All patients were outpatients when participating in this study with an average illness duration of 20.36 years (std: 13.01 years). All but four patients were medicated with antipsychotic drugs (averaged CPZ dose equivalent = 387.9 mg (std: 359.0 mg)) (Woods, 2003
Face perception questionnaire (subjective)
Table 2 presents average ratings for each item of the face perception questionnaire as well composite scores. The composite scores differed significantly between the two participant groups (t = 3.57, p < 0.001), indicating degraded quality of everyday face-related experience in the patient group. For the ratings of individual items, the two groups were significantly different in item 1 (t = 2.71, p < 0.01), item 2 (t = 2.27, p < 0.05) and item 5 (t = 2.43, p < 0.05), but not in other items.
Psychophysical measurements (objective)
Discussion
Face perception in schizophrenia patients was degraded, as evaluated by both the subjective and the objective assessments. Unlike in healthy controls, face-related everyday experience in schizophrenia patients is neither associated with the basic perceptual capacity to discriminate facial identities, nor with the social cognitive ability to ascribe a correct emotion state to others (Theory of Mind).
Contributions
The manuscript presents original material and has not been considered for publication elsewhere. Both authors have made substantial contributions to this work. Yue Chen designed the study and prepared the manuscript. Tor Ekstrom performed the surveys, the psychological tests and data analysis, and revised the manuscript. Both authors had full access to the data and approved this manuscript for submission.
Role of funding source
This work was supported in part by a grant from NIH (MH R01 096793).
Acknowledgment
The authors thank Dr. Ongur for supervision of clinical evaluation, Dr. Maher for discussion of Capgras delusion, and Ms. Salcone for comments on the paper.
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